Abstract
BackgroundPhysicians’ ability to make cost-effective decisions has been shown to be affected by their knowledge of health care costs. This study assessed whether Portuguese family physicians are aware of the costs of the most frequently prescribed diagnostic and laboratory tests.MethodsA cross-sectional study was conducted in a representative sample of Portuguese family physicians, using computer-assisted telephone interviews for data collection. A Likert scale was used to assess physician’s level of agreement with four statements about health care costs. Family physicians were also asked to estimate the costs of diagnostic and laboratory tests. Each physician’s cost estimate was compared with the true cost and the absolute error was calculated.ResultsOne-quarter (24%; 95% confidence interval: 23%–25%) of all cost estimates were accurate to within 25% of the true cost, with 55% (95% IC: 53–56) overestimating and 21% (95% IC: 20–22) underestimating the true actual cost. The majority (76%) of family physicians thought they did not have or were uncertain as to whether they had adequate knowledge of diagnostic and laboratory test costs, and only 7% reported receiving adequate education. The majority of the family physicians (82%) said that they had adequate access to information about the diagnostic and laboratory test costs. Thirty-three percent thought that costs did not influence their decision to order tests, while 27% were uncertain.ConclusionsPortuguese family physicians have limited awareness of diagnostic and laboratory test costs, and our results demonstrate a need for improved education in this area. Further research should focus on identifying whether interventions in cost knowledge actually change ordering behavior, in identifying optimal methods to disseminate cost information, and on improving the cost-effectiveness of care.
Highlights
The Portuguese National Health Service (NHS) is a large health care organization that serves almost 10 million beneficiaries and contains a strong core of primary care physicians; 87.1% of Portuguese have family physicians[1]
Portuguese family physicians have limited awareness of diagnostic and laboratory test costs, and our results demonstrate a need for improved education in this area
According to the 2009/2010 activity report of the Central Administration of the Health Service, laboratory examinations and diagnoses in ambulatory care constitute a significant proportion on total health expenses and represent about 8% of the expenses of the Portuguese NHS [3]
Summary
The Portuguese National Health Service (NHS) is a large health care organization that serves almost 10 million beneficiaries and contains a strong core of primary care physicians; 87.1% of Portuguese have family physicians[1]. In terms of health policy and in the context of significant budget constraints related to the current economic and financial situation, Portugal requires increased accuracy and accountability in the area of health management. According to the 2009/2010 activity report of the Central Administration of the Health Service, laboratory examinations and diagnoses in ambulatory care constitute a significant proportion on total health expenses and represent about 8% of the expenses of the Portuguese NHS [3]. Units of primary health care are the most representative entities in terms of costs of prescriptions[3]. This study assessed whether Portuguese family physicians are aware of the costs of the most frequently prescribed diagnostic and laboratory tests
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